Thoughts on Senior Moments

  2010
 
A REFUGE

For those who need it. . .

 

             COMPASSION and CARE

During their sunset years . . .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A Concept Paper and Proposal by:

 

Ven Jo Tesoro

 Mobile: 0921 2658920

http://philippineprison.wordpress.com/

Joel Villanueva

Mobile: +63(932) 637-5953

Email: jmdvillanueva@gmail.com

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A project for the elderly, to be temporarily called ‘Balay Pasilungan’ is proposed as a social service outlet.  It is to be implemented by any meaningful social movement or NGO, through the desk for Senior Citizens, for the purpose of providing shelter and care for the marginalized elderly in our society – as a refuge for the homeless, abandoned and destitute who no longer have families to go home to.  In this refuge, they shall be provided with holistic care – physical, psychological, social and spiritual – to give them comfort from a long life of deprivation and to spend their remaining years in dignity, peace and contentment.

 

The ‘Balay Pasilungan’ hospice facility calls for a 250-square meter facility that can accommodate 25 elderly wards and staff within a minimum of 1,500-square meter lot.  This ‘home-for-25-elderly’ module is believed to be the optimum configuration that is most manageable and replicable, having trained volunteers and staff, imbibed with the competence and commitment to provide valued care for their wards.

 

 

WHAT REALITY IS

 

The age group ‘65-year old and above’ comprises 4.32% of today’s total Philippine population of 88.6 Million, or some 3.9 Million that can be considered as the ‘elderly’.  Moreover, the ‘70-year old and above’ group make up 62% of this number, or some 2.4 Million who may be requiring more attention and care than those younger.  By the year 2020, the population is projected to reach 111.7 Million, with this age group increasing to 5.58% of the total, or 6.23 Million.  The ’70-year old and above’ would number to some 3.9 Million by then, or another 1.5 Million elderly more than what it is at present.

 

The Department of Social Welfare and Development (DSWD), on one hand, currently estimates that a third of 1% of our total population, or some 300,000 elderly can be considered within the category of the homeless, abandoned and destitute.  Unless the economy drastically improves, their number will increase to some 375,000 elderly under this category by 2020.

The hospice movement now counts only 23 institutions and 520 service providers on record since it was formally introduced in the Philippines in 1993.  Hospice care does not seek to cure.  It seeks to provide an “improved” quality of life during the remaining days of the elderly, and where their physical and spiritual needs could be met.

At one time or another, a family will be taking care of a sick loved one.  Whether a terminally ill person will be spending his or her remaining days in a hospital or at home depends on many factors — one’s financial means, the family’s compassion and support network, and the facilities available.  The homeless, abandoned and destitute, however, do not enjoy any of these options and are simply left to fend for themselves.

Another of the most challenging tasks of hospice facilities is the recruitment of volunteers.  Hospice care is essentially difficult and volunteers must have a special calling for this particular vocation.  To deal with death openly, as one takes care of the elderly, requires strength that can only come from a conviction for a nobler purpose.  The continuing development of volunteers and staff to competently man future facilities is an equal challenge, as the need to have more trainors and training facilities to hasten the formation of hospice units in the country also exists.

 

WHAT CAN BE DONE

 

While the need of the vast population of 4.9 Million elderly will have to be addressed, the proposed ‘Balay Pasilungan’ project will limit and concern itself only with the estimated 300,000 homeless, abandoned and destitute elderly who may be in this category.  This paper will, therefore, promote only the construction and establishment of physical facilities, and the operation of hospice care.  Although equally crucial, the training and manpower development component shall be dealt with as a separate undertaking or program in partnership with state universities and/or appropriate agencies.

 

As no reliable data are immediately available on the carrying capacity of the existing 23 institutions, or whether the 520 service providers are employed by them or operate independently, this paper will assume that a maximum of a hundred can be accommodated by each institution, or 2,300, and each of 520 service providers take care of 10 wards each, or 5,200 elderly.  Though these data are just being inferred for now, they will be further validated.  This estimate, however, assumes that those presently involved in hospice care can reach out to as much as 7,500 elderly only, or put it at 10,000 to be conservative.  This, therefore, leaves some 290,000 elderly still out in the streets without the benefit of shelter and the minimum of care.

 

Based on this preferred module of 250-square meters for 25 elderly wards, this proponent concludes that some 11,600 of such modules would be necessary to address this pressing need, if not the urgent attention that is being demanded for this neglected sector of our society.   Their number is indeed staggering, and their living condition remains short of appalling.

 

In Davao City alone, there are 33,000 in the age bracket of 65 years old and above, with 19,600 comprising the 70 years old and above.  If we are to go by the DSWD estimate of 1/3 of 1% of the population being in the category of the homeless, abandoned and destitute, this would mean that there would be 110 and 65 constituents of Davao City who are in the 65-year old and above, and 70-year old and above brackets, respectively, in that category.  Based on such 25-elderly module, it would take two such facilities to address them.

 

The City Government of Davao is, however, only one among the not-too-many that is desirous and capable of taking up the challenge of extending meaningful social service, for them to live humanely, if not decently and in peace.  This gap, therefore, presents a golden opportunity for reaching out to give them the attention they simply deserve as human beings, as well as the recognition for having served time for their transgression to society.  This world can be made a better place for our elderly to live in during their ‘pre-departure’ phase, and there can be no quantifiable returns or political gains for such gesture.

 

While providing such care is basically an obligation and a function of government, the magnitude to be addressed is so enormous that it calls for both civil society to be involved and give back directly to society, and for government to ensure that funds are strictly appropriated for the elderly, as mandated, to serve the purpose they were intended for.  Private sector participation – institutions, organizations, and individual alike – in partnership with government and in the spirit of a sincere commitment to do what is good and what is right, is a winning combination that can make this happen with a more-than-even chance of succeeding.

 

The City Government of Davao may, therefore, engage professional management or collaborate with organizations for the construction of replicable modular physical facilities, hospice care operations, and manpower training.  The Office of the Mayor shall lead and be one with others, and together, bridge this vast social gap.

 

 

HOW IT IS

 

Providing two (2) such homes over the next two years in Davao City is not a mind-boggling quantity, and it is certainly not out of reach.  The training and human development of the thousands who will be manning such facilities is, likewise, an intimidating challenge but will be addressed separately and competently.

 

It is said that a journey of a thousand miles is always started with one step.  The City Government of Davao may take this step as a government-initiated project, together with the already existing 23 institutions and the other 520 like-minded service providers.  While the bigger population can be considered as the ambitious long-term goal, it can be chopped down into chewable and manageable pieces for other private individuals or organizations, and for government agencies and state universities that have the heart to embrace this advocacy, to make it happen and be realized sooner than later.

 

Role of Government

 

Government’s care for our elderly is mandated and enshrined in our Constitution, and in various policy pronouncements and implementing guidelines of government, which are outlined as Annex “A”.  This section will just emphasize pertinent provisions as the legal bases for succeeding discussions on the project:

  1. Joint Circular No. 2003-01 of the DSWD and DBM, dated 28 April 2003, highlighting the following salient provisions:
  2. 4.2 of Policy Guidelines that state “ All government agencies, departments, bureaus, offices, commissions and state universities and colleges shall allocate at least one percent (1%) of their respective budget for the implementation of plans, programs, projects, activities and services for older persons and persons with disabilities”;
  3. 4.3 “The funds shall be utilized ….. in either of the following”:

i.    4.3.2 “Human Resource Development . . . in the areas of”:

  • Counselling, professional guidance and family therapy for emotional support for family caregivers
  • Specialized skills training for professionals and service providers for older persons and persons with disabilities

ii.    4.3.5  Group Home / Foster Home for neglected, abandoned, and detached older persons and persons with disabilities

iii.    4.3.8   Other programs / projects / activities / services the agencies may implement to address the needs of the older persons and persons with disabilities as these relate to their respective mandates.  The budget allocated . . .  can be attributed as part of the 1 percent allocation.

  1. General Appropriations Act, Section 34 – Programs / Projects related to Senior Citizens and the Differently-Abled.  In support of the Philippine Plan of Action for Older Persons 2005 – 2009, the cost of implementing plans, programs, and projects intended to address the concerns of senior citizens and differently-abled shall be at least one percent (1%) of the agency’s total budget appropriations.

Our country’s political subdivision is composed of 17 Regions, 81 Provinces, 136 Cities, 1,495 Municipalities, and 41,995 Barangays.  The Congress of the Philippines has 23 Senators; and 238 Representatives – 216 elected and 22 from the party list.

The Local Government Units have an Internal Revenue Allotment of 210.7 Billion, of which 20%, or 4.21 B, is earmarked as the LGUs’ development fund.   The combined budget of the State Universities, the DOH, DPWH and DSWD alone, total a whopping 138 Billion, 1% of which would amount to P1.38 Billion.

Although there are laws that outline the benefits for senior citizens, and executive department directives that allocate the source of funds for the elderly and the differently-abled, there is, sadly, no deliberate program of government that is in place to address the need to establish hospice care facilities and their operation, when it is, in fact, urgent but doable.  This concept paper attempts to discuss why it must be done, and how it can be done by government in partnership with the private sector, even if only to scratch the surface initially.

 

WHAT WE CAN DO, TOGETHER

 

Constructing, operating, and replicating thousands of hospice facilities is the ambitious long-term goal, but initial efforts can be considered meaningful if even two (2) of these facilities is targeted and achieved over the next 2 years.  The project’s general objectives are, therefore, as follows:

  1. To, construct, establish, and replicate one modular hospice care facility for 25 elderly each within Davao City by 2011;
  2. To operate and provide value care to the homeless, abandoned and destitute;
  3. To recruit, train, and employ volunteers and staff that will man each of these hospice care facilities; and,
  4. To put a system in place that will actualize the access, availment and application of the 1% government’s budget in realizing the above three objectives.

Toward these, the following immediate objectives will, likewise, have to be met:

  1. To establish functional collaboration with, and assist appropriate partner government agencies in the preparation of common and/or joint activities which can be embraced as their own project and program for the elderly and disabled, to meaningfully apply the mandated 1% allocation of government’s budget, but implemented through a consultancy engagement;
  2. To identify community leaders or civic organizations, and government officials who will simultaneously champion this cause for the elderly toward its fruition and assurance of the continuing operation of a hospice care facility within these target areas; and,
  3. To identify a property with a minimum of 1,500 square meters, more or less, (for the structure and activity areas) that will be made available for a module, either as donation or long-term usufruct arrangement, specifically, for hospice care operation.

 

PROJECT COMPONENTS and COSTS

 

The project is best described as the adoption and replication of a ‘hospice care system’, the components of this system, being: a) the construction and establishment of the physical structures and prescribed amenities; and, b) the manual of operations for the management of such hospice care facility.

It is only proper to view these distinct activities as one system, as it simply wishes to ensure that construction of the structure is executed as per design and specification, at the least cost based on accepted current standard practice; and, that the facility is managed efficiently and operated perpetually as ‘home with compassion and care’ facility it is intended to be.

Physical Structure

The 1,500-square meter property shall accommodate open activity areas, and the efficiently designed 250-square meter covered facility which shall house: two wings of dormitory for men and women separately; kitchen, dining area which also serves as the activity area; receiving area that opens up to the garden; isolation room for 2 to 3 terminally-ill elderly; quarters for staff; office space; stock room; and, laundry and drying areas.

The cost of construction of the 250-meter structure is being estimated based on a low construction industry standard of P12,000 per square meter or P3.0 M, plus a 10% allowance for contingencies, or rounded to a total of P3.30 Million.

The remaining 1,250 square meters shall be landscaped and to include: pathways, benches, areas for meditation, vegetable garden, etc. and, the utility shed and power house estimated to cost P200,000.00.

This total project cost for the construction of the facility and grounds improvement component shall amount to P3.50 Million.

The layout of the facility and its functional areas shall be designed upon a firm expression of interest and commitment.

Hospice Care

The cost components for the operations of the facility shall consider both the one-time capital expenditures, and the yearly recurring working capital requirements.

The capital expenditures required to set up and equip such a facility is estimated to amount to P400,000.00 while the working capital requirement shall be a total of P 1.9 M per annum.

In summary, the one-time cost shall cover the construction of the facility and landscaping at P3.50 and capital expenditure of P400,000 for equipment and accessories, or a total of P3.90M.  The working capital requirement of P1.9M shall be a yearly recurring cost.

The total program cost of the system package or module will, therefore, be P5.80 Million for the first year.  Details of the application of funds, and the projected annual cost up to 2020 which takes into account a 3.5% inflation rate (as against the current 12.5%), is attached as Annex “B”.

 

TIMETABLE and ACTIVITIES

The schedule below illustrates the annual ramp-up toward the establishment of facilities to meet the target volume of 2 modules over the next 2 years:

Year

‘11

‘12

‘13

‘14

‘15

‘16

‘17

‘18

‘18

‘20

‘21

‘22

                         

Modules per year

1

1

Cumulative

1

2

2

2

2

2

2

2

2

2

2

2

 

Toward meeting this timetable, the following general and pre-requisite activities will be undertaken:

  1. Identify and document the properties where the facilities will be established, either as a donation or a long-term usufruct agreement to the Balay Pasilungan project;
  2. Design and layout the modular facility to determine the bill of materials and equipment requirement, for actual costing in collaboration with the City Architect;
  3. Collaborate with an existing hospice, and/or with State Universities and Colleges having medical, nursing, or care-giving courses to design the manual of operations that take into account the staffing requirements, nutrition, monitoring and medication, program of daily activities, etc.;
  4. Enter into Memoranda of Agreement (MOAs) with appropriate government agencies like the Departments of Social Welfare and Development (DSWD), Public Works and Highways (DPWH), Health (DOH), etc.; and, with Non-governmental organizations (NGOs); in developing and implementing joint programs for the elderly;
  5. Enter into MOAs with community leaders and/or civic organizations and/or local and foreign foundations, and/or elected Representatives and/or Senators who may, partially or in full, sponsor or front-end the cost of construction and one year’s operation of the hospice care facility; and,
  6. Set up the system for funds flow and application of funds, monitoring and evaluation, and reporting.

The preceding activities shall be the pre-operating phase which shall be conducted over a period of three (3) months.

 

 

STRUCTURE & IMPLEMENTATION

 

The Balay Pasilungan project shall be funded with P100,000 by the Office of the Mayor to cover the pre-operating expenses for the above activities of the first 3 months, during which the necessary agreements for operations and subsequent funding will be perfected.  The project shall be structured to qualify to accept donations and foreign or domestic grants.

 

The construction of the facilities and the first year’s operations, on the other hand, will be front-ended by the City Government of Davao as their social outlet or compliance with the mandate to allocate 1% for projects for the elderly and disabled, and/or the PDAF of Senators or Congressmen, or a combination thereof, who are predisposed to support such programs for the elderly.

 

This shall serve as interim start-up funding while institutionalizing the system of availing the 1% of government agencies is being documented and perfected, and its fund release is being awaited.  When the equivalent funds from the 1% have been released, they will have the option to be reimbursed or to utilize the same to replicate succeeding project modules.

 

CONCLUSION

 

As of this writing, a minimum 1,500-square meter property it is felt that such may be a government property or an abandoned building or acquired asset by a bank, which may be easily committed to the project as a site for a hospice facility of the Balay Pasilungan Project.  Another similar property within Davao City shall be identified once the first module is operational.

 

The ‘Kalinga at Kalayaan’ project shall be spearheaded by the Office of the Mayor and supported by concerned and enlightened government agencies, as well as the private sector.  The City Government of Davao simply wishes to share its wealth of goodwill in reaching out to the extremely marginalized sector of our society – the homeless, abandoned and destitute, and released prisoners – with those who have the heart to embrace its advocacy of providing “a REFUGE for those who need it. . .  COMPASSION and CARE during their sunset years.

 

 

 

Ven Jo Tesoro

June 2010

 

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About Ven J. Tesoro

writer, prison officer, artist
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